Theatre

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Biological Agents

Risk of:

  • Infection.

Possible causes:

  • Exposure to Blood Borne Viruses (BBVs) via puncture wounds or cuts from scalpels, blades, suture and injection needles, cutting devices, bone fragments or via splashes to mucous membranes.
  • Exposure to microorganisms in laser plumes.

Chemical Agents

Risk of:

  • Health hazards such as respiratory problems, allergies and dermatitis.
  • Fire.
  • Explosion.
  • Burns.

Possible causes:

  • Improper handling of compressed gases.

Exposure to:

  • Latex consumables.
  • Smoke plumes from laser or electrosurgical units.
  • Waste anaesthetic gases (enflurane, isoflurane, sevoflurane, desfulrane, halothane) due to patient exhalation, poor gas connections or poor maintenance of scavenging system.
  • Methyl methacrylamide during bone surgery.
  • Disinfectants.
  • Cryogenic agents during cryosurgical procedures.
  • Hazardous drugs via inhalation or during injection or administration.

Ergonomic Hazards

Risk of:

  • Pain in neck, back or arms.
  • Musculoskeletal disorders such as carpel tunnel syndrome.
  • Fatigue.

Possible causes:

  • Static, awkward postures or sustained postures e.g. forward bent head and neck.
  • Poorly designed tools.
  • Use of high grip forces.
  • Standing for long periods of time, holding limbs, wearing heavy lead aprons.
  • Lack of height adjustable work surfaces.
  • Poorly designed transport trolleys and storage areas e.g. shelving above shoulder height.
  • Lack of job rotation.

 

Electricity

Risk of:

  • Fire.
  • Electric shock.
  • Burns.
  • Death.

Possible causes:

  • Faulty equipment.
  • Improperly grounded equipment.
  • Overloading of sockets.
  • Unsafe work practices.
  • Equipment unsuitable for the work environment.
  • Electrical leads crossing areas where fluids pool or contact with saline based irrigation.

Fire

Risk of:

  • Burns.
  • Smoke inhalation.
  • Death.

Possible causes:

  • Use of lasers, electrosurgical or electrocautery equipment.
  • Use of fibre optic lights sources and cables.
  • Spark production from high speed drills, lasers and electrosurgical units.
  • Presence of oxygen enriched environment - oxygen, nitrous oxide, trapping of oxygen under surgical drapes.
  • Presence of flammable materials and alcohol based prepping agents.
  • Failure to put laser into standby mode when not in use.
  • Unmaintained equipment.

Ionising Radiation

Risk of:

  • Genetic or reproductive damage.

Possible causes:

  • Exposure whilst carrying out X-rays, treatments using radioactive implantations, after loading or administration of radioactive therapeutic agents.
  • Carrying out emergency procedures on patients who have received therapeutic amounts of radionuclides.
  • Lack of PPE.
  • Lack of warning signs e.g. on entrance to room.

 

Manual / Patient Handling

Risk of:

  • Back injury, sprains and strains.

Possible causes:

  • Lack of mechanical handling equipment.
  • Improper lifting technique or over exertion.
  • Lifting heavy sets / instrument trays, infusion and irrigation fluids.
  • Supporting static loads.
  • Use of high grip forces in awkward positions.
  • Lifting, transferring and repositioning sedated and anaesthetised patients.

 

Non-Ionising Radiation

Risk of:

  • Eye damage / visual problems.
  • Skin burns.
  • Respiratory problems.
  • Fire.
  • Electric shock.
  • Physical injury.
  • Nausea, headaches, tinnitus, fatigue.

Possible causes:

  • Improper connection and handling of diathermy equipment.
  • Lack of shielding / failure to block beams or stray reflections.
  • Failure to wear eye protection or follow safe systems of work.
  • Inadequate training.
  • Lack of Local Exhaust Ventilation (LEV).
  • Laser beams not kept away from flammable liquids, gases and vapours.

Exposure to:

  • Chemical hazards in laser plumes such as nanoparticles, dusts, and vapours during excision and cauterisation of tissues.
  • Microwaves or radio-frequency radiation when performing diathermy surgery.
  • Magnetic fields and medical ultrasound.
  • Reflected or directly transmitted laser beams.

 

Sharps

Risk of:

  • Infection.
  • Cuts.

Possible causes:

  • Exposure to sharp medical instruments, broken bone fragments, glass from motor vehicle collision patients or needle sticks.
  • Handling and passing by hand, instruments, blades, sutures and scissors.

 

Slips, Trips and Falls

Risk of:

  • Minor injuries such as cuts to major injuries such as broken bones, concussion and even death.

Possible causes:

  • Wet or slippery floors.
  • Debris on floor.
  • Inappropriately placed electric cables.
  • Rushing in emergency situations.
  • Loose medical tubing, loose cords and cables.

 

Stress

Risk of:

  • Psychological disorders.
  • Health effects.

Possible causes:

  • Attending to severely traumatised patients.
  • Coping with multiple disaster victims.
  • Making life or death decisions.

Vibration

Risk of:

  • Adverse health effects.

Possible causes:

  • Use of poorly designed or maintained bone drills / saws.

Further Information

For further information on related controls click here.

Note: This is not an exhaustive list of hazards and risks.